Now that I’ve survived my month of ICU (and actually enjoyed it–love that high acuity stuff), I should clear up some misconceptions about the ICU that I definitely had coming in (and that likely most people have about ICUs).

You walk through an Intensive Care Unit and see almost everyone totally sedated and out of it: on a ventilator, with lines going in their arms, legs, necks, urethras, and rectums, and lines of plastic tubing entrapping them, and you think, My God, why are we keeping these poor people alive on a ventilator? They’re too sick to make it, just let them go already! Americans don’t know how to let their loved ones go!

So it turns out: while most people in the ICU at any one time are really sick and totally out of it, every day there’s at least a few people who are getting better, getting various tubes removed from them, and actually getting out of the ICU. I had this big impression that few people make it out of an ICU–that most people die, and the ICU is some sort of “last ditch” effort. While it’s true that we can’t save everyone, and some people are just too sick for us to save, the vast majority of our patients did really well after suffering some seriously major insults to their bodies. It’s truly miraculous what people’s bodies can deal with with some support during the really bad times from the ICU.

6 Comments »

My thoughts about the ICU, starting chronologically from my first day until now, starting my third week:

Pre-ICU:
Boy, I think I’m really starting to get decent at clerkships–I feel like I’ve got a good grasp of management for most diseases, I can present pretty well, I’m keeping up with the interns on my service. I’ll learn a lot in the ICU!

ICU, Days One and Two: (aka Why Being A Med Student Sucks)
I hate this. I hate hate hate this. I am stupid, I don’t know anything. These patients are too complex! They’re overwhelming! It takes me an hour just to collect data on all these patients! What the hell are all these ventilator settings? All these random numbers? And the numbers keep changing! And there’s like 4 ABG’s drawn every day! Ugh, this sucks! I don’t know how to present, I turned bright red trying to present this patient to the 19 person team, full of residents, fellows, and attendings (no interns, just med students), and my attending had to take over and explain everything cause I screw it all up! And I called LeMierre’s Syndrome Meniere’s Disease and ugh, did I mention I HATE THIS?

ICU, The Rest Of Week One
Well it’s a brand new team of residents and first year fellows, most of which haven’t done the ICU in a long time or ever before, so I’m on more equal ground now. Lectures are starting over with “What Is ACLS?” and “How do I manage shock?” and everyone is getting confused on how to present patients in morning and afternoon rounds. This is muuuuch better. I feel much less like a dumbass. (But still a dumbass.)

ICU, Week Two
Okay, I’m getting the hang of this. Stuff’s starting to make sense. I can round on my patients pretty quickly, get all the relevant data and not fall too far behind. Big picture. Remember the big picture–what’s keeping the patient in the ICU? What are we doing for them that can’t be done on the floor? Why are they so sick? Still getting lots of suggestions for management from the rest of the team, but I’m getting a better hang of things–what needs to be presented and what can just be recorded in the note. The patients are really sick, and really interesting, and man, one patient can be a review of every system in the body. Kind of… cool. (For learning, not for the patient.)

Two weeks down, two weeks to go!

5 Comments »

I don’t think I’ve ever seen so many young people in the hospital before. And they’re all in the Intensive Care Unit (ICU).

Scary how many people are around my age or younger, and how really sick they are, with diseases and on drugs I’ve never even heard of. We youngin’s are generally a healthy bunch, but man, when we get sick, we tank .

And man, when us youngin’s are taking care of you, we’ve got a lot to read. Posting may be light this month. Ugh.

Comments Off on Young People Get Sick Too